Chlorhexidine

Surgical site infection (SSI) is one of the most frequent health care-associated infections. One of the practices to reduce their incidence is preoperative skin antisepsis. Two of the most commonly active components used are chlorhexidine gluconate and povidone iodine. Of 3 reviews conducted between 2010 and 2012 comparing antiseptics, 2 were in favor of chlorhexidine; however, the latest was unable to draw conclusions. To verify whether recent evidence supports the hypothesis that chlorhexidine in preoperative antisepsis is more efficient than other antiseptics in reducing SSI rates. We conducted a systematic review from 2000-2014 in all languages. The primary end point was SSI incidence and secondary skin bacterial colonization. Nineteen studies were included. Meta-analysis were conducted for comparable studies for both outcomes. The results of the meta-analysis, including all of the studies in which chlorhexidine was compared with iodophor, were in favor of chlorhexidine for both...

The efficacy of antimicrobial central venous catheters (CVCs) remains questionable. In this network meta-analysis, we aimed to assess the comparative efficacy of antimicrobial CVC impregnations in reducing catheter-related infections in adults. We searched 4 electronic databases (Medline, the Cochrane Central Register of Controlled Trials, Embase, CINAHL) and internet sources for randomized controlled trials, ongoing clinical trials, and unpublished studies up to August 2016. Studies that assessed CVCs with antimicrobial impregnation with nonimpregnated catheters or catheters with another impregnation were included. Primary outcomes were clinically diagnosed sepsis, catheter-related bloodstream infection (CRBSI), and all-cause mortality. We performed a network meta-analysis to estimate risk ratio (RR) with 95% confidence interval (CI). Sixty studies with 17255 catheters were included. The effects of 14 impregnations were investigated. Both CRBSI and catheter colonization were the mo...

The aim of this work was the evaluation of conductivity assessments for the monitoring and controlling the release study process of chlorhexidine and lidocaine hydrochloride from the ionic polyacrylic gel, applying different temperatures. According to performed measurements of release, the chlorhexidine, characterized by very low water solubility, is observed in the acceptor compartment in the amount of 2.0-3.0% and its level depends of the temperature. The amount of well soluble lidocaine hydrochloride released in parallel conditions was between 60 and 70%. Beyond, the assessments confirm the presence of a specific bond between the chlorhexidine imine groups and polyacrylic acid carboxylic groups. Presented method may be applied in the prediction of release rates, before actual release analysis, and may assure better evaluation of the systems.

Chlorhexidine gluconate is a relatively commonly used chemotherapeutic in the treatment of periodontitis (P), exhibiting antimicrobial capabilities against Gram-negative and Gram-positive bacteria, and fungi. This compound is a component of various preparations for topical use in the form of solutions for mouthrinsing or peri-irrigation, gels, varnishes, chips and even chewing gums. The aim of the study was the clinical evaluation of periodontium after treatment with one of the drugs containing chlorhexidine gluconate (Corsodyl) as compared to professional tooth cleaning in patients with chronic periodontitis. MATERAL AND METHODS: Forty subjects enrolled in the study were divided into four groups, 10 in each group, according to the mode of treatment (Corsodyl rinse, Corsodyl gel, Corsodyl gel + surgical dressing, scaling). The greatest differences between baseline and follow-up examinations were observed in the group where surgical dressing was applied in addition to Corsodyl gel an...

Recent research indicated that periopathogens colonize, besides the pockets, also other niches within the oral cavity including: the soft tissues, the saliva, the tongue, and even the tonsils. Since the supragingival plaque and the bacteria in these niches have a major impact on the ...

Several scientific works increasingly focus on the bacterial resistance caused by the prolonged use of antiseptics and antibiotics. Chlorhexidine is the most commonly used molecule in dentistry. There are many works that prove the effectiveness of Chlorhexidine, but its use is connected with collateral events. Massive use of Chlorhexidine would induce antibiotic resistance, for example for Klebsiella pneumoniae. Urticaria, severe rash, hissing breath, difficult breathing, cold sweats, light head feeling; swelling of the face, lips, tongue or throat are described during use of chlorhexidine. This medication can cause severe irritation or chemical burns in young children. Based on these considerations, the disadvantage risk of using these products should be carefully re-evaluated. The health of the oral cavity will be increasing re-evaluated and closely linked to human health.

Compare the efficacy of the cleaning technique usually employed in our healthcare facility to eliminate environmental contamination with cyclophosphamide with that of the Surface Safe commercial kit. This is a three-step evaluative and comparative study involving: (i) the voluntary contamination of the surface of a hood with a pre-established quantity of cyclophosphamide (20,000,000 ng), (ii) the cleaning of the work surface of the hood using a cleaning technique usually employed in our healthcare facility or that of the product Surface Safe, and (iii) the quantification of cyclophosphamide detected on the work surface. The usual cleaning technique involves the use of a mixture of 0.05% chlorhexidine and 70% ethyl alcohol to clean surfaces, whereas the product Surface Safe involves a combined two-step sodium hypochlorite and sodium thiosulfate wash. The median concentrations of cyclophosphamide detected after the use of the usual technique and the product Surface Safe came to 165 ng...

SUMMARY Objective This in vitro study evaluated the influence of different cleansing techniques on the bond strength of self-adhesive cement to dentin. Methods and Materials A total of 33 noncarious human molars were sectioned mesiodistally and embedded in chemically cured resin with the buccal or lingual surfaces facing upward. Superficial dentin was exposed and resin disk provisional restorations were cemented to the dentin surfaces with noneugenol provisional cement and were stored in distilled water at 37°C. After seven days, the provisional restorations were removed and 13 specimens were randomly assigned to each of the five groups (n=13), according to the following cleansing treatments: G1—excavator (control); G2—0.12% chlorhexidine digluconate; G3—40% polyacrylic acid; G4—mixture of flour pumice and water; and G5—sandblasting with 50 μm aluminum oxide particles at a pressure of 87 psi. Resin composite disks (Filtek Supreme Plus, 3M ESPE Dental Products, St Paul, MN, USA) 4.7 ...

Aim: This study evaluated the bond strength of glass-fiber posts (GFP) to intrarradicular dentin in cervical, middle and apical thirds, after using ultrasonically activated irrigants. Methods: One hundred and twenty lower premolars sectioned and distributed into 10 groups (n=12), according to irrigant and ultrasonic treatments. The groups were 2.5% NaOCl (HS), 2% chlorhexidine digluconate (CL), 17% EDTA, saline (SF) distilled water (AD), plus or minus ultrasonic instrumentation, and posts were cemented whith RelyX ARC. Results: The bond strength was evaluated by means of the push-out test. Repeated measures three-way analysis of variance and Tukey test revealed that compared to EDTA 17%, CL and SF significantly reduced the bond strength of GFP, regardless of ultrasonic instrumentation and also independently from root third (p=0.015). The most prevalent failure type was adhesive between the dentin and cement for the EDTA and HS groups, followed by mixed failure for the CL and HS groups. GFP bond strength was not affected by ultrasonic instrumentation (p=0.114), nor was it different between root thirds (p=0.280). Conclusion: The GFP bond strength to root dentin was influenced by the irrigant used, being the greatest values obtained with 17% EDTA when compared to CL and SF with or without passive ultrasonic instrumentation.

Bisphosphonate induced necrosis of the jaws (BONJ) does not have a unique protocol of treatment and many therapeutic approaches have been arising in oral medicine with debatable results. A male and a female attended the University Oral Surgery Clinic presenting oral bone lesions induced by intravenous and oral bisphosphonates respectively as complications of dental extraction. Treatment included daily mouthwashes and weekly intra oral irrigations with 4 mg/L of aqueous-ozone, antibiotic therapy and sequential superficial debridment for sequestrectomies. Long-standing follow-ups showed complete mucosa covering of exposed bone area and resolution of purulent secretion. Antibacterial and antifungal properties of aqueous ozone may have played important roles in the treatment. The outcome measured intra oral examination and panoramic radiographs of the affected bone. The application of aqueous ozone daily mouthwashes and weekly professional irrigation were safe; free from adverse effects...

This study evaluates the effect of subgingival irrigation with a 1% chlorhexidine collagen gel in periodontal pockets as an adjunct procedure to scaling and root planing (SRP). Thirty-seven sites with probing depth (PD) of 5-7 mm and BANA positive in 6 patients with chronic periodontal disease were selected. Sites were assigned to different treatment groups consisting of SRP only (group 1), SRP + irrigation with collagen gel (group 2), or SRP + irrigation with collagen gel containing 1% chlorhexidine (group 3). Subgingival irrigation was performed after initial SRP and at 7, 14 and 21 days. Clinical measurements including PD, plaque index (PI), gingival index (GI), gingival recession (GI), bleeding on probing (BOP) and clinical attachment level (CAL) were performed at the selected sites at baseline, 60 and 90 days and the BANA test was performed on plaque samples from the same sites at baseline and 90 days. There was an improvement in clinical parameters in all groups with a signifi...

Since chlorhexidine is effective against microorganisms, it is widely recommended in dentistry. However, studies have provided evidence that chlorhexidine is toxic for a variety of cell types. In order to identify potential genotoxins in different cell types, the purpose of this study was to investigate whether chlorhexidine digluconate is able to cause, in terms of DNA damage, alterations in leukocytes, liver, kidney and urinary bladder by the single cell gel (comet) assay. Ten male Wistar rats were divided into two groups: a negative control and the experimental group treated with 3 ml of 0.12% chlorhexidine digluconate by gavage once a day for 8 days. Statistically significant increases of DNA damage was observed in leukocytes and kidney cells of the chlorhexidine digluconate treated group as depicted by the mean tail moment. Taken together, the data indicate that leukocytes and kidney cells are potential targets for primary DNA damage following oral exposure to chlorhexidine digluconate as detected by single cell gel (comet) assay.

Carica papaya is traditionally used to treat various skin disorders, including wounds. It is widely used in developing countries as an effective and readily available treatment of various wounds, particularly burns. This study was aimed at investigating the healing efficiency of papaya latex formulated as 1.0 and 2.5% hydrogels. Burns were induced in Swiss albino mice divided into five groups as following; Group-I (negative control) received no treatment. Group-II was treated with Carbopol 974P NF empty gel. Groups-III and -IV were treated with Carbopol gel containing 1.0 and 2.5% of dried papaya latex, respectively. Group-V (positive control) received the standard drug (silver sulphadiazine and chlorhexidine gluconate cream). The efficacy of treatment was evaluated based on the hydroxyproline content, wound contraction and epithelialization time. Hydroxyproline content was found to be significantly increased in the Group-III. Significant increase in percentage wound contraction was observed from day 12 in Group-IV and from day 20 in Groups-III and -V. The epithelialization time was found to be the shortest in Group-IV. It may be concluded that papaya latex formulated in the Carbopol gel is effective in the treatment of burns and thus supports its traditional use.

The article describes the pharmacocodynamics of povidone-iodine, the release form under the brand name Betadine, pharmacological benefits, as well as evidence of its effectiveness in preventing infection in the field of surgical intervention. Povidone-iodine is indicated to be a depot of iodine, constantly releasing elemental iodine, which has strong oxidizing properties, and therefore most microorganisms are destroyed in vitro in less than a minute, and the main destructive effect of the drug occurs in the first 15–30 seconds. Povidone-iodine has a wide spectrum of antimicrobial and antiviral action.

The data on medications of povidone-iodine in the form of vaginal suppositories, antiseptic solution and ointment under the trade name Betadine are presented. Own data on the effective use of vaginal suppositories in symptomatic vaginal dysbiosis caused by mixed opportunistic bacterial flora (facultative and obligate anaerobes) with the presence of Atopobium vaginae in diagnostically significant amounts are presented.

In the presented comparative studies, the advantages of Betadine compared with other antiseptics in the spectrum of microbiological effects, resistance of microorganisms, effects on wound healing, dependence of the effect on the physico-chemical parameters of the environment, side effects, the purpose of application – prevention and/or treatment are shown.

The results of recent comparative studies on the treatment of the surgical area with chlohexidine-alcohol and povidone-iodine, according to which povidone-iodine should still be considered acceptable for the preoperative treatment of the caesarean section, are highlighted. It is indicated that the irrigation of the wound cavity with an aqueous solution of povidone-iodine during surgery and before suturing the surgical wound is one of the WHO recommendations for the prevention of infection in the field of surgical intervention.

The authors conclude that povidone-iodine, including Betadine, has a broad spectrum of antimicrobial and antiviral activity; high activity in the presence of organic compounds (blood, pus); ability to penetrate through biofilms, necrotic tissue, eschar; low incidence of antiseptic resistance; positive dynamics of wound healing by preventing the spread of inflammation and increasing the ability to heal; well tolerated by patients; low cost; ease of use.